The role of anticoagulation in acute ischemic stroke and secondary prevention of ischemic stroke has been changed in the last years. Several large studies could not demonstrate a significant benefit of early anticoagulation in patients with acute stroke. Possible remaining indications for acute anticoagulation were an undoubtful cardioembolic cause of the stroke, progressive stroke, introcranial sinus venous thrombosis, dissections of cerebral arteries and high grade carotid stenosis before CEA. For secondary prevention of cardioembolic stroke anticoagulation is the first line treatment. Recently anticoagulation is discussed in patients with persistent foramen ovale and atrial septum aneurysm (ASA). For the treatment of intracranial stenosis oral anticoagulation might be better than aspirin.
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The role of anticoagulation in acute ischemic stroke and secondary prevention of ischemic stroke has been changed in the last years. Several large studies could not demonstrate a significant benefit of early anticoagulation in patients with acute stroke. Possible remaining indications for acute anticoagulation were an undoubtful cardioembolic cause of the stroke, progressive stroke, introcranial sinus venous thrombosis, dissections of cerebral arteries and high grade carotid stenosis before CEA....
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